Reaching people soon after a traumatic event: an exploratory observational feasibility study of recruitment in the emergency department to deliver a brief behavioral intervention via smartphone to prevent intrusive memories of trauma

Marie Kanstrup, Ann Rudman, Katarina Göransson, Emil Andersson, Klara Olofsdotter Lauri, Emma Rapoport, Linda Sunnergård, Maria Bragesjö, Erik Andersson, Lalitha Iyadurai, Emily A Holmes, Marie Kanstrup, Ann Rudman, Katarina Göransson, Emil Andersson, Klara Olofsdotter Lauri, Emma Rapoport, Linda Sunnergård, Maria Bragesjö, Erik Andersson, Lalitha Iyadurai, Emily A Holmes

Abstract

Background: The current study explored how to recruit patients soon after a traumatic event, to deliver a novel intervention in a new emergency department in Sweden. This brief behavioral intervention aims to prevent intrusive memories and is delivered soon after trauma in the emergency department. In the UK, it has shown promising results. Traumatic events resulting in admission to the emergency department (e.g., road traffic accidents) may result in subsequent mental health problems such as post-traumatic stress disorder, where intrusive memories of the trauma constitute a core clinical feature. Early interventions that prevent intrusive memories after psychological trauma are lacking. Specific aims were to explore identification of eligible patients (aim 1), fitting in with emergency department staff routines to deliver the study protocol (aim 2), and using the patients' own smartphones to deliver intervention/control task (aim 3). Two changes to the previous study were (i) extending the trauma types included (ii) a new control condition, also by smartphone.

Methods: This is an explorative observational study. Data was both analyzed descriptively and using the Framework method.

Results: We identified several possible ways to recruit patients, and establish a sense of embeddedness in the Swedish emergency department context and a positive appreciation from staff. The study protocol was tested with 8 participants. Tasks both in the intervention and control condition were readily delivered via patients' own smartphones.

Conclusion: Recruitment of patients and smartphone delivery of the intervention indicates initial feasibility. Researcher presence and administration of study procedures was successfully fitted to emergency department routines and well received by staff. Further pilot work is warranted, underscoring the importance of our collaboration between nursing and psychology.

Keywords: Behavior therapy; Emergency service; Feasibility studies; Hospital; Memory; Mobile applications; Patient selection; Psychological trauma; Smartphone; Telemedicine.

Conflict of interest statement

EAH reports grants from the Swedish Research Council, The Lupina Foundation, grants from The Oak Foundation, during the conduct of the study. EAH reports serving on the Editorial Advisory Board of The Lancet Psychiatry. EAH reports serving on the board of the charity MQ: Transforming Mental Health (UK). EAH receives book royalties from Oxford University Press and Guilford Press, and occasional fees from clinical workshops and conference keynotes, outside the submitted work. EAH reports her primary affiliation is Department of Psychology, Uppsala University, Sweden (90%), and is also a professor at Division of Psychology, Department for Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (10%).

ErA receives book royalties for a book on health anxiety. Other authors report no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
The analytical framework developed regarding the identification of eligible patients (aim 1)

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